Illinois General Assembly - Full Text of HB3995
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Full Text of HB3995  102nd General Assembly




State of Illinois
2021 and 2022


Introduced 3/4/2021, by Rep. Robyn Gabel


New Act

    Creates the Birth Center Licensing Act. Provides that, except as provided by the Act, no person shall open, manage, conduct, offer, maintain, or advertise as a birth center without a valid license issued by the Department of Public Health. Requires all birth centers in existence as of the effective date of the Act to obtain a valid license to operate within 2 years after the adoption of rules by the Department to implement the Act. Provides that an applicant for a license under the Act shall submit an application on forms prescribed by the Department, which shall be accompanied by a nonrefundable license fee, as established by rule by the Department. Provides that licenses under the Act are renewable every 3 years upon submission of specified materials. Requires birth centers, to the extent possible, to link and integrate services with nearby health care facilities. Contains provisions concerning staffing requirements; minimum standards to protect the health and safety of a patient of a birth center; and requirements for reimbursement, reporting, training, and inspections. Requires the Department to adopt specified rules. Contains other provisions. Effective immediately.

LRB102 14648 CPF 21906 b






HB3995LRB102 14648 CPF 21906 b

1    AN ACT concerning regulation.
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
4    Section 1. Short title. This Act may be cited as the Birth
5Center Licensing Act.
6    Section 5. Definitions. In this Act:
7    "Birth center" means a designated site, other than a
9        (1) in which births are planned to occur following a
10    normal, uncomplicated, and low-risk pregnancy;
11        (2) that is not the pregnant person's usual place of
12    residence;
13        (3) that is exclusively dedicated to serving the
14    childbirth-related needs of pregnant persons and their
15    newborns, and has no more than 10 beds; and
16        (4) that offers prenatal care and community education
17    services and coordinates these services with other health
18    care services available in the community.
19    "Department" means the Department of Public Health.
20    "Hospital" does not include places where pregnant females
21are received, cared for, or treated during delivery if it is in
22a licensed birth center, nor include any facility required to
23be licensed as a birth center.



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1    Section 10. License required. Except as provided by this
2Act, no person shall open, manage, conduct, offer, maintain,
3or advertise as a birth center without a valid license issued
4by the Department. All birth centers in existence as of the
5effective date of this Act shall obtain a valid license to
6operate within 2 years after the adoption of rules by the
7Department to implement this Act under Section 60.
8    Section 15. Issuance and renewal of license.
9    (a) An applicant for a license under this Act shall submit
10an application on forms prescribed by the Department. Each
11application shall be accompanied by a nonrefundable license
12fee, as established by rule by the Department under Section
14    (b) The Department may grant a temporary initial license
15to an applicant. A temporary initial license expires on the
16earlier of the date the Department denies the license or the
17date 6 months after the temporary initial license was issued.
18    (c) The Department shall issue a license if, after
19application, inspection, and investigation, it finds the
20applicant meets the requirements of this Act and the rules and
21standards adopted pursuant to this Act.
22    (d) A license is renewable every 3 years upon submission
23of (i) the renewal application and fee and (ii) a report on a
24form prescribed by the Department that includes information



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1related to quality of care at a birth center. The report must
2be in the form and documented by evidence as required by the
3Department by rule under Section 60.
4    Section 20. Linkages.
5    (a) A birth center shall, to the extent possible, link and
6integrate its services with nearby health care facilities.
7    (b) A birth center shall have a written plan for transfer
8of patients that addresses emergency and nonemergency
9situations for both pregnant persons and newborns in
10antepartum, intrapartum, and postpartum phases. This should
11include plans for communication with the receiving hospital
12before and after transfer.
13    Section 25. Staffing.
14    (a) A birth center shall have a clinical director, who may
16        (1) a physician who is either certified or eligible
17    for certification by the American College of Obstetricians
18    and Gynecologists or the American Board of Osteopathic
19    Obstetricians and Gynecologists or has hospital
20    obstetrical privileges; or
21        (2) a midwife who is either certified or eligible for
22    certification by his or her governing body.
23    (b) The clinical director shall be responsible for:
24        (1) the development of policies and procedures for



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1    services as provided by Department rules;
2        (2) coordinating the clinical staff and overall
3    provision of patient care;
4        (3) developing and approving policies defining the
5    criteria to determine which pregnancies are accepted as
6    normal, uncomplicated, and low-risk; and
7        (4) developing and approving policing regarding the
8    anesthesia services available at the center.
9    (c) An obstetrician, family practitioner, or midwife
10licensed in Illinois shall attend each person in labor from
11the time of admission through birth and throughout the
12immediate postpartum period. Attendance may be delegated only
13to another physician or midwife licensed in Illinois.
14    (d) A second staff person shall be present at each birth
16        (1) is licensed or certified in Illinois in a
17    health-related field and under the supervision of a
18    physician or a licensed midwife in Illinois that is in
19    attendance;
20        (2) has specialized training in labor and delivery
21    techniques and care of newborns; and
22        (3) receives planned and ongoing training as needed to
23    perform assigned duties effectively.
24    Section 30. Minimum standards.
25    (a) The Department's rules adopted pursuant to Section 60



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1of this Act shall contain minimum standards to protect the
2health and safety of a patient of a birth center. In adopting
3rules for birth centers, the Department shall consider:
4        (1) the Commission for the Accreditation of Birth
5    Centers' Standards for Freestanding Birth Centers;
6        (2) the American Academy of Pediatrics and American
7    College of Obstetricians and Gynecologists Guidelines for
8    Perinatal Care; and
9        (3) the Regionalized Perinatal Health Care Code.
10    Section 35. Quality of care. The Department's rules shall
11provide for a time period within which each birth center must
12become accredited by either the Commission for the
13Accreditation of Freestanding Birth Centers or The Joint
15    A birth center shall implement a quality improvement
16program consistent with the requirements of the accrediting
18    Section 40. Reimbursement requirements.
19    (a) A birth center shall seek certification under Titles
20XVIII and XIX of the federal Social Security Act.
21    (b) Reimbursement rates set by the Department of
22Healthcare and Family Services should be based on all types of
23medically necessary covered services provided to both the
24birthing person and the baby, including:



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1        (1) a professional fee for both the birthing person
2    and baby;
3        (2) a facility fee for the birthing person that is no
4    less than 75% of the statewide average facility payment
5    rate made to a hospital for an uncomplicated vaginal
6    birth;
7        (3) a facility fee for the baby that is no less than
8    75% of the statewide average facility payment rate made to
9    a hospital for a normal baby; and
10        (4) additional fees for other services, medications,
11    laboratory tests, and supplies provided.
12    (c) A birth center shall provide charitable care
13consistent with that provided by comparable health care
14providers in the geographic area.
15    (d) A birth center may not discriminate against any
16patient requiring treatment because of the source of payment
17for services, including Medicare and Medicaid recipients.
18    Section 45. Reporting requirements. The Department shall
19by rule require each birth center to report information every
203 years that is consistent with the birth center's license
21renewal schedule, which the Department shall make publicly
22available and which shall include the following:
23        (1) utilization data involving patient length of stay;
24        (2) admissions and discharges;
25        (3) complications;



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1        (4) transfers;
2        (5) deaths;
3        (6) any other publicly reported data required under
4    the Consumer Guide to Health Care; and
5        (7) post-discharge patient status data where patients
6    are followed for 14 days after discharge from the birth
7    center to determine whether the mother or baby developed a
8    complication or infection.
9    Section 50. Training. A birth center shall establish and
10implement a policy to ensure appropriate training and
11competency of individuals employed within the birth center.
12The policy shall, at a minimum, define the acts and practices
13that are allowed or prohibited for such employees, establish
14how training will be conducted, and illustrate how initial
15competency will be established.
16    Section 55. Inspections; special inspections; reports.
17    (a) The Department shall deem an accreditation body
18applicable to birth centers as a substitute for its own
19periodic inspection. The Department, whenever it determines
20necessary, may conduct a special inspection, survey, or
21evaluation of a birth center to assess compliance with
22licensure requirements and standards or a plan of correction
23submitted as a result of deficiencies cited by the Department
24or accrediting body.



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1    (b) Upon the Department's completion of any special
2inspection, survey, or evaluation, the appropriate Department
3personnel who conducted the special inspection, survey, or
4evaluation shall submit a copy of his or her report to the
5licensee upon exiting the birth center, and shall submit the
6actual report to the appropriate regional office.
7    (c) The Department's report and any recommendation for
8action under this Act shall be sent to the Department's
9central office together with a plan of correction from the
10birth center.
11    (d) The plan of correction may contain related comments or
12documentation provided by the birth center that may refute
13findings in the report, explain extenuating circumstances that
14the birth center could not reasonably have prevented, or
15indicate methods and timetables for correction of deficiencies
16described in the report.
17    (e) A birth center has 10 days after the date of the
18Department's special inspection, survey, or evaluation to
19submit a plan of correction. The Department shall determine
20whether a birth center is in violation of this Section no later
21than 60 days after completion of each special inspection,
22survey, evaluation, or plan of correction.
23    (f) The Department shall maintain all special inspection,
24survey, or evaluation reports for at least 5 years in a manner
25accessible to the public.



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1    Section 60. Rules.
2    (a) The Department shall adopt rules for the
3administration and enforcement of this Act.
4    (b) Rules adopted by the Department under this Act shall
6        (1) the eligibility criteria for birth center
7    admission that are consistent with accreditation standards
8    and the midwife's or physician's scope of practice;
9        (2) the necessary equipment for emergency care
10    according to the Commission for Accreditation of Birth
11    Centers' standards;
12        (3) the travel time distance from the birth center
13    that is not located within a rural area and a general acute
14    care hospital with which the birth center the maintains a
15    transfer agreement that allows for an emergency cesarean
16    delivery to be started within 30 minutes of the decision
17    that a cesarean delivery is necessary;
18        (4) the travel time distance from the birth center
19    that is located within a rural area and a general acute
20    care hospital with which the birth center maintains a
21    transfer agreement that allows for an emergency cesarean
22    delivery to be started within 45 minutes of the decision
23    that a cesarean delivery is necessary;
24        (5) that the use of general anesthesia at a birth
25    center is prohibited; and
26        (6) the equipment used by the birth center to ensure



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1    that it is compatible with the health and safety of the
2    patients.
3    Section 99. Effective date. This Act takes effect upon
4becoming law.